NPI | 1619748779 |
---|---|
Former Name | MICHELLE ELAINE YOUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4008833) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY KY46199) |
207R00000X Internal Medicine (Licence: KY KY45185) | |
Enumeration Date | 2024-01-09 |
Last Update Date | 2024-05-23 |