NPI | 1063511087 |
---|---|
Former Name | AMANDA GAYLE CHRISTENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OR PA01154) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2023-06-12 |