| NPI | 1114330420 |
|---|---|
| Former Name | AMANDA MARIE FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-11491) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10051109) |
| 207Q00000X Family Medicine (Licence: TX R0161) | |
| 207Q00000X Family Medicine (Licence: TN 56184) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: AR E-11491) | |
| 208000000X Pediatrics (Licence: AR E-11491) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2023-07-05 |