NPI | 1497001812 |
---|---|
Former Name | AMANDA MARIE LYNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 58104) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58104) |
Enumeration Date | 2012-08-03 |
Last Update Date | 2020-10-29 |