| NPI | 1407357775 |
|---|---|
| Former Name | AMANDA LYNN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00621200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062799) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2024-10-28 |