NPI | 1154923555 |
---|---|
Former Name | AMANDA YETTA MOHAMED |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 345414) |
Additional Taxonomies | 208D00000X General Practice (Licence: HI 3036) |
363LF0000X Nurse Practitioner, Family (Licence: NY F345414-01) | |
363LF0000X Nurse Practitioner, Family (Licence: HI 3036) | |
Enumeration Date | 2020-11-10 |
Last Update Date | 2024-09-18 |