| NPI | 1710066287 |
|---|---|
| Former Name | KIMBERLY DAWN STATLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO DR0053849) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR0053849) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2021-05-14 |