NPI | 1710106059 |
---|---|
Former Name | AMANDA LEA PRICE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 0534830) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-6053) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2019-11-22 |