| NPI | 1013178797 |
|---|---|
| Former Name | AMANDA KATHRYN BLOCKINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD28515) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 60018395) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2016-07-07 |