| NPI | 1326137498 |
|---|---|
| Former Name | AMY BOESCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10000914A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000914) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-07-21 |