| NPI | 1609013408 |
|---|---|
| Former Name | AMY ELIZABETH KUCZKOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2376) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 2376-23) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2023-11-06 |