| NPI | 1144822396 |
|---|---|
| Former Name | AMANDA MARIE MACKENZIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IL 209021666) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: IL 309016356) |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2022-04-20 |