| NPI | 1982256236 |
|---|---|
| Former Name | AMANDA MAYHEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12118651-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 12118651-1206) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2022-08-28 |