| NPI | 1346485984 |
|---|---|
| Former Name | AMANDA FORDHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 13854) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 162358) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2017-05-11 |