NPI | 1962099390 |
---|---|
Former Name | YLLENA MARIE POPOVICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014120) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1159096) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3014120) | |
Enumeration Date | 2020-12-31 |
Last Update Date | 2020-12-31 |