| NPI | 1548884398 |
|---|---|
| Former Name | AMANDA J. DURHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 58867) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58867) |
| Enumeration Date | 2020-06-07 |
| Last Update Date | 2024-12-19 |