NPI | 1073920823 |
---|---|
Former Name | AMANDA KRISTOFIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8064) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014170) |
Enumeration Date | 2014-07-14 |
Last Update Date | 2023-03-15 |