| NPI | 1265470652 |
|---|---|
| Former Name | AIDA ROSE HOLLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4866P) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001525A) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-03-07 |