| NPI | 1952612749 |
|---|---|
| Former Name | AMBER NIELSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5061) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.679) |
| 363A00000X Physician Assistant (Licence: NM PA2011-0002) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2012-07-13 |