| NPI | 1497264618 |
|---|---|
| Former Name | AMANDA MARIE ETTINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017826) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP017826) |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2020-06-16 |