NPI | 1912172917 |
---|---|
Former Name | KIMBERLY ELIZABETH HANLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 279619) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 243623) |
Enumeration Date | 2008-04-30 |
Last Update Date | 2018-11-12 |