| NPI | 1689096000 |
|---|---|
| Former Name | KIMBERLY SUSAN GUDEX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5702-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 163710-30) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2021-01-07 |