NPI | 1609879162 |
---|---|
Other Name | LEAH BLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4140P) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001612A) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2012-09-06 |