| NPI | 1275013526 |
|---|---|
| Former Name | AMANDA RENEE HARRISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 08390) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2025-10-06 |