| NPI | 1831497106 |
|---|---|
| Former Name | AMANDA LYNN DICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA183299) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21501) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2022-07-21 |