| NPI | 1871855403 |
|---|---|
| Former Name | AMANDA FREDERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS018112) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT014518) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2016-04-05 |