| NPI | 1477850915 |
|---|---|
| Former Name | AMANDA RUTH THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001003738) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001003738) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2022-11-10 |