NPI | 1790220143 |
---|---|
Former Name | AMANDA RICHARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A0053338) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 118856) |
Enumeration Date | 2016-12-21 |
Last Update Date | 2023-05-09 |