NPI | 1275941700 |
---|---|
Former Name | AMANDA R KASTENMEIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 3373-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3373) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2024-08-12 |