NPI | 1134934128 |
---|---|
Former Name | AMANDA LEANN INNIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: KS 13-141506-061) |
Enumeration Date | 2025-02-08 |
Last Update Date | 2025-02-08 |