| NPI | 1205276748 |
|---|---|
| Former Name | AMANDA SUZANNE FOSTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2013018188) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2015-07-13 |