| NPI | 1861975484 |
|---|---|
| Former Name | AMANDA WOOLSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 0010-08338) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2022-03-31 |