| NPI | 1184073421 |
|---|---|
| Former Name | AMANDA KATHLEEN GROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0013171) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT210838) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-06-19 |