| NPI | 1649529884 |
|---|---|
| Former Name | AMANDA FIELDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106714) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9106714) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2024-05-24 |