NPI | 1972548865 |
---|---|
Former Name | KIMBERLY KAY SILVERNAIL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA00804) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00804) |
363A00000X Physician Assistant (Licence: OR ORPA00804) | |
Enumeration Date | 2006-06-17 |
Last Update Date | 2020-12-22 |