| NPI | 1447652193 |
|---|---|
| Former Name | AMANDA SORRENTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 003179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 03179) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2018-10-08 |