NPI | 1821088600 |
---|---|
Former Name | KIMBERLY JILL WOODLEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN PA1187) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN PA1187) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2010-01-20 |