| NPI | 1154984292 |
|---|---|
| Former Name | AMANDA LEANN MCCORMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 67772) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30347) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2023-02-03 |