NPI | 1154404135 |
---|---|
Former Name | AMY E ALTLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA052717) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052717) |
363A00000X Physician Assistant (Licence: MD C003800) | |
Enumeration Date | 2006-10-23 |
Last Update Date | 2019-12-03 |