| NPI | 1720426901 |
|---|---|
| Former Name | AMANDA LYNN TARNOWICZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A141541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116025759) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-02-09 |