NPI | 1033537683 |
---|---|
Former Name | AMANDA JO CARPENTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: VA 0101260303) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101260303) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2023-06-27 |