| NPI | 1407376262 |
|---|---|
| Former Name | AMANDA KIRSTIN BAUMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4085) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2020-12-15 |