NPI | 1417258906 |
---|---|
Former Name | AMANDA LYNN JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 85003878) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA53923) |
Enumeration Date | 2010-11-15 |
Last Update Date | 2020-09-18 |