| NPI | 1578112363 |
|---|---|
| Former Name | AMANDA GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277001619) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 277.001619) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2024-10-04 |