NPI | 1336384478 |
---|---|
Former Name | AMANDA M BOSTDORF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010063) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP010063) |
Enumeration Date | 2008-12-03 |
Last Update Date | 2021-01-27 |