NPI | 1295158913 |
---|---|
Former Name | AMANDA KATLIN DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-993) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AR PA-993) |
363A00000X Physician Assistant (Licence: CA PA51724) | |
Enumeration Date | 2014-01-31 |
Last Update Date | 2024-04-01 |