| NPI | 1215284971 |
|---|---|
| Former Name | AMANDA CORINNE BUKATY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75953) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 75953) |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2018-10-24 |