NPI | 1720115421 |
---|---|
Former Name | MOLLY J BRADSHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005094) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 3005094) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2022-12-08 |