| NPI | 1811364300 |
|---|---|
| Former Name | AMY DETTMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9327671) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9327671) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2024-08-19 |