| NPI | 1366691289 |
|---|---|
| Former Name | AMY NICOLE STOCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 1137) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA053577) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2015-12-07 |