NPI | 1063979458 |
---|---|
Former Name | AIESHA N WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 57852) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1121062) |
Enumeration Date | 2019-02-21 |
Last Update Date | 2020-09-09 |