| NPI | 1720507270 |
|---|---|
| Former Name | AMANDA MARIE HAGL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021306) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00484600) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2023-07-25 |