| NPI | 1104278043 |
|---|---|
| Former Name | AMANDA KAYE WATTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9119077) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2016-07-03 |
| Last Update Date | 2024-10-01 |