NPI | 1073697546 |
---|---|
Former Name | AMY GOODWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004138) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4138P) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2019-01-23 |