| NPI | 1093147019 |
|---|---|
| Former Name | AMANDA MAZUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9404125) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA14920-NP,RN344880) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2016-09-28 |