| NPI | 1861712465 |
|---|---|
| Former Name | KIMBERLY MICHELLE KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0992581) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 130535) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2022-07-21 |