NPI | 1891284790 |
---|---|
Former Name | AMANDA MARIE STAHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS021508) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-05-07 |
Last Update Date | 2022-03-16 |