| NPI | 1710486808 |
|---|---|
| Former Name | AMANDA LEIGH BROOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902526) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902526) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2020-07-28 |