| NPI | 1346632098 |
|---|---|
| Former Name | MARY AMANDA CLINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06741) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA-TF-0191) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2022-12-08 |