| NPI | 1558702696 |
|---|---|
| Former Name | AMANDA NICOLE PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IN 26024542A) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 016031) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2016-04-07 |