| NPI | 1598316424 |
|---|---|
| Former Name | KIM SOUTHAM-GEROW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0024178278) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2020-08-20 |