NPI | 1740616010 |
---|---|
Former Name | KIMBERLY K BAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2473) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003082A) |
363A00000X Physician Assistant (Licence: OH 003842) | |
Enumeration Date | 2013-09-18 |
Last Update Date | 2024-06-21 |