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Individual
KIMBERLY BARDALL
Active
Individual
KIMBERLY BARDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
SP030028
PA
363L00000X
Nurse Practitioner
Primary
SP030028
PA
Other
Enumeration date
07/09/2024
Last updated
10/31/2024
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