NPI | 1730571365 |
---|---|
Former Name | CAROLYN MONROE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009123) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 3009123) |
367H00000X Anesthesiologist Assistant (Licence: KY 3009123) | |
Enumeration Date | 2015-02-18 |
Last Update Date | 2020-04-20 |