| NPI | 1477942092 |
|---|---|
| Former Name | AMANDA NICOLE ROTERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015000406) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209027428) |
| 363L00000X Nurse Practitioner (Licence: IN 71015197A) | |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2024-06-07 |