| NPI | 1639170970 |
|---|---|
| Former Name | AMY C PODWORSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001216) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 1495) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 001216) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-07-31 |