NPI | 1518564632 |
---|---|
Former Name | AMANDA ELAINE DEAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MI 4704308597) |
Enumeration Date | 2020-10-01 |
Last Update Date | 2023-06-23 |