NPI | 1972889749 |
---|---|
Former Name | AMANDA VALERIE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5008082) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305540-1) |
Enumeration Date | 2011-10-25 |
Last Update Date | 2023-11-07 |