| NPI | 1710259833 |
|---|---|
| Former Name | AMY MARIE SHUTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11886) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 207P00000X Emergency Medicine (Licence: TX PA11886) | |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2020-06-11 |