| NPI | 1760815955 |
|---|---|
| Former Name | AMY CLARE LALLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2013-0042) |
| 363A00000X Physician Assistant (Licence: AL PA.1156) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2021-11-05 |