| NPI | 1154085504 |
|---|---|
| Former Name | AMANDA MARIE FAMEREE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 11401-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704384074) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-12-08 |