| NPI | 1588051973 |
|---|---|
| Former Name | KIMBERLY ANN DEELSTRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: UT 10105490-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2016-10-12 |