| NPI | 1417026410 | 
|---|---|
| Former Name | AMANDA J THOMSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200850093NP)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI APRN-220)  | 
| Enumeration Date | 2006-11-06 | 
| Last Update Date | 2021-12-07 |