NPI | 1770533713 |
---|---|
Former Name | AMY L. DENNIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME 1980) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1238) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2023-11-14 |