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 |