| NPI | 1245662535 |
|---|---|
| Former Name | AMY LUCAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031667) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0968) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2023-12-04 |