| NPI | 1649804816 |
|---|---|
| Former Name | AMANDA WEDDERSPOON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5012-23) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 5012-23) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2022-10-27 |