| NPI | 1477134880 |
|---|---|
| Former Name | KENNEDY GOODE |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24894) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 24894) |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2025-01-14 |