| 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 |