NPI | 1942970769 |
---|---|
Former Name | AMANDA LOHMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 62758) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 8659) |
363AS0400X Physician Assistant, Surgical (Licence: AZ 8659) | |
Enumeration Date | 2021-09-14 |
Last Update Date | 2023-11-22 |