| NPI | 1720442858 |
|---|---|
| Former Name | AMANDA MICHELLE JACOBSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60951609) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60951609) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2020-11-11 |