| NPI | 1457799934 |
|---|---|
| Former Name | AMANDA JOANNE KALK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001011045) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031484) |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical (Licence: DE C5-0001001) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2021-10-12 |