NPI | 1699352484 |
---|---|
Former Name | AMANDA MARTHA WOROBEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008787) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9113988) |
Enumeration Date | 2021-03-26 |
Last Update Date | 2022-09-28 |