NPI | 1003352626 |
---|---|
Former Name | HOLLY MARIE LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3010934) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3010934) |
Enumeration Date | 2017-01-07 |
Last Update Date | 2023-05-17 |