NPI | 1730774944 |
---|---|
Former Name | KIMBERLY BRINCKERHOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017002) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95185521) |
Enumeration Date | 2021-03-09 |
Last Update Date | 2021-07-25 |