NPI | 1679632673 |
---|---|
Former Name | KIMBERLY ANN POCHE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200047RX) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200047RX) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2014-07-08 |