NPI | 1699021113 |
---|---|
Former Name | AMANDA L MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007445) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007445) |
Enumeration Date | 2012-08-02 |
Last Update Date | 2023-05-24 |