NPI | 1912201955 |
---|---|
Former Name | AMANDA M CANDELA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020453-1) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055549) |
Enumeration Date | 2011-01-05 |
Last Update Date | 2021-02-25 |