| NPI | 1215721006 |
|---|---|
| Former Name | AMANDA SHELLEY BERGMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2026-04-19 |