| NPI | 1023774221 |
|---|---|
| Former Name | AMANDA RAE BEAMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110008195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008195) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2024-08-29 |