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 |