| NPI | 1336481308 |
|---|---|
| Former Name | AMANDA C DE DONATO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3991) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-004153) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2019-09-17 |