NPI | 1528628674 |
---|---|
Former Name | AMANDA P MCGINNIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351045541) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01088018A) |
207Q00000X Family Medicine (Licence: MI 4301505105) | |
Enumeration Date | 2019-06-19 |
Last Update Date | 2023-12-19 |