| NPI | 1629537345 |
|---|---|
| Former Name | AMY POLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0009392) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 107020) |
| 363AS0400X Physician Assistant, Surgical (Licence: WY PT10112) | |
| 363A00000X Physician Assistant (Licence: NE 2341) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2025-10-31 |