NPI | 1902850217 |
---|---|
Former Name | KIMBERLY DAWN LAUDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 1686) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 1686) |
Enumeration Date | 2006-05-20 |
Last Update Date | 2013-05-23 |