| NPI | 1659024610 |
|---|---|
| Former Name | MARISSA AMENT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA01559) |
| 363AM0700X Physician Assistant Medical (Licence: PA MA063342) | |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2023-09-30 |