| NPI | 1487823266 |
|---|---|
| Former Name | AMY MARIE DEWANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-04257) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053266) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2023-05-01 |