| NPI | 1194074815 |
|---|---|
| Former Name | AMANDA JO MCMAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-794) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2018-03-27 |