| NPI | 1952706897 |
|---|---|
| Former Name | AMANDA RUTH RICHARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08005) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN123165) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2016-05-09 |