| NPI | 1144340167 |
|---|---|
| Former Name | AMANDA JEAN GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301087741) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087741) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2014-05-08 |