NPI | 1942261995 |
---|---|
Former Name | KIMBERLY C BOERSMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 3467) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R7671) |
207Q00000X Family Medicine (Licence: IL 036-111283) | |
Enumeration Date | 2006-03-29 |
Last Update Date | 2021-03-02 |