| NPI | 1457805020 |
|---|---|
| Former Name | AMANDA MICHELLE STUTSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12245) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2023-01-16 |