NPI | 1356726277 |
---|---|
Former Name | AMANDA C LEITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005205RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108826) |
Enumeration Date | 2015-07-21 |
Last Update Date | 2018-03-20 |