| NPI | 1073746632 |
|---|---|
| Former Name | AMANDA LOUISE FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12794) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002020) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2021-07-09 |