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 |