NPI | 1841464732 |
---|---|
Former Name | AMANDA DAWN SAN U |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 5323) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 1715) |
Enumeration Date | 2008-04-22 |
Last Update Date | 2024-12-12 |