| NPI | 1265912976 |
|---|---|
| Former Name | AMANDA FABIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MD R200689) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: PA RN693077) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |