| 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 |