| NPI | 1174875223 |
|---|---|
| Former Name | AMY ANN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005048) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085005048) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 5214) | |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2023-01-13 |