NPI | 1295088821 |
---|---|
Former Name | AMANDA L COCHRAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3709-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004518) |
Enumeration Date | 2012-10-19 |
Last Update Date | 2023-12-18 |