| NPI | 1164796942 |
|---|---|
| Former Name | AMANDA ELAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101280445) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NE 27508) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2024-05-08 |