| NPI | 1760769657 |
|---|---|
| Former Name | KIMBERLY KATHRYN VANDE WYDEVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 170300000X Genetic Counselor, MS (Licence: CA GC000547) |
| Additional Taxonomies | 170300000X Genetic Counselor, MS (Licence: IL 246.000119) |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2014-11-17 |