| NPI | 1407521248 |
|---|---|
| Former Name | MIKAYLA DODSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016181) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3016181) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2022-11-11 |