| NPI | 1366909103 |
|---|---|
| Former Name | AMANDA KATHRYN CONNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ME PA1902) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ME PA1902) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2020-02-19 |