NPI | 1568747939 |
---|---|
Former Name | KIMBERLE LYNNE BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C05727) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030787) |
363A00000X Physician Assistant (Licence: CO PA0003586) | |
Enumeration Date | 2011-10-18 |
Last Update Date | 2016-01-20 |