| NPI | 1932543493 |
|---|---|
| Former Name | AMANDA GRUENHAGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015014595) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP9058) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2022-05-20 |