| NPI | 1649522269 |
|---|---|
| Former Name | KIMBERLY CARDOSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71004172A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004172A) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2021-05-13 |