NPI | 1447594486 |
---|---|
Former Name | AMANDA JEAN ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 17136) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17136) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2015-08-03 |