| NPI | 1114274917 |
|---|---|
| Former Name | AMANDA CHEVESTICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00293900) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2024-03-28 |