| NPI | 1265959613 |
|---|---|
| Former Name | AMANDA HOLLOWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 021440) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 21440) |
| Enumeration Date | 2017-08-26 |
| Last Update Date | 2023-07-17 |