| NPI | 1790278778 |
|---|---|
| Former Name | AMANDA PUTRUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008688) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2020-02-01 |