| NPI | 1871932731 |
|---|---|
| Former Name | AMANDA ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NE 31811) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 125.063736) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2019-07-19 |