| NPI | 1265829394 |
|---|---|
| Former Name | AMANDA LYNN CALLEGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 312618) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 312618) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2023-09-27 |