| NPI | 1487834305 |
|---|---|
| Former Name | AMIE MICHELLE MALKUCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 67546) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ND PAC0378) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2018-11-15 |