| NPI | 1942478698 |
|---|---|
| Former Name | AMANDA DIMITROFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2571) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2022-08-05 |