| NPI | 1568467272 |
|---|---|
| Former Name | AMANDA GRACE YARBROUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 104075) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 104075) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2018-06-27 |