| NPI | 1033410550 |
|---|---|
| Former Name | AMY M PETTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 17757) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 17757) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2018-10-26 |