NPI | 1689078974 |
---|---|
Former Name | AMY ELIZABETH KNISSEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61143707) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 1390) |
Enumeration Date | 2014-10-15 |
Last Update Date | 2023-07-31 |