| NPI | 1134598881 |
|---|---|
| Former Name | AMANDA NICOLE STIDHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 802889) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2017-02-14 |