NPI | 1710314257 |
---|---|
Other Name | AMY CHRISTINE HACKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085011274) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59764) |
363AM0700X Physician Assistant, Medical (Licence: WI 7475) | |
Enumeration Date | 2013-09-30 |
Last Update Date | 2025-07-22 |