NPI | 1003249079 |
---|---|
Former Name | AMANDA BRICKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013057) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013057) |
Enumeration Date | 2013-08-14 |
Last Update Date | 2021-01-09 |