| NPI | 1932623840 |
|---|---|
| Former Name | AMY COOPER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011407) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 10362797-4405) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2019-02-04 |