| NPI | 1467019935 |
|---|---|
| Former Name | AMANDA GOETZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71010990A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013394) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-05-02 |