| NPI | 1962867341 |
|---|---|
| Former Name | AMANDA BUSSELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006552) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2025-01-09 |