NPI | 1326588260 |
---|---|
Former Name | AMANDA HEGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020776) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174599) |
Enumeration Date | 2017-02-26 |
Last Update Date | 2024-04-26 |