| NPI | 1962598367 |
|---|---|
| Former Name | AMY M GONZENBACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108881) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085002812) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-11-12 |