| NPI | 1750811691 |
|---|---|
| Former Name | AMELIA GRACE MCCANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8365) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 8365) |
| 208000000X Pediatrics (Licence: GA 8365) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2020-07-13 |