NPI | 1548613219 |
---|---|
Former Name | AMANDA GENTNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: UT 7410114-4405) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 7410114-4405) |
Enumeration Date | 2016-07-18 |
Last Update Date | 2021-11-11 |