| NPI | 1982885067 |
|---|---|
| Former Name | AMANDA J BLAIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 2006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002006) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2020-03-04 |