| NPI | 1821057910 |
|---|---|
| Former Name | AMY MARIE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 9768) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: MN 9768) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2018-11-30 |