| NPI | 1669984423 |
|---|---|
| Former Name | AMANDA NICOLE BAHLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX 1013660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA11513) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2024-05-24 |