| NPI | 1023426475 |
|---|---|
| Former Name | AMANDA LANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.011799) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A114990) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2024-11-18 |