| NPI | 1952760571 |
|---|---|
| Former Name | TAYLOR KIMBLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4108) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110-005228) | |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2024-05-09 |