NPI | 1457335093 |
---|---|
Former Name | KIMBERLY M JURCZYK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA 1552) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1552) |
Enumeration Date | 2005-12-06 |
Last Update Date | 2022-12-13 |