| NPI | 1598066409 |
|---|---|
| Former Name | AMY LEE HANSCOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: ME PA305) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA305) |
| 363A00000X Physician Assistant (Licence: ME PA001243) | |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2023-06-27 |