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 |