| NPI | 1609619691 |
|---|---|
| Former Name | AMANDA GALLAHTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.010647) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2025-10-30 |