| NPI | 1659675601 |
|---|---|
| Former Name | KIMBERLY ANNE BOSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209008549) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209008549) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2023-07-11 |