NPI | 1699217273 |
---|---|
Former Name | AMANDA LYNN CONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008068) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-11-14 |
Last Update Date | 2022-08-11 |