NPI | 1003380098 |
---|---|
Former Name | EMILY LAUREN VOYNOVICH NORDSTROM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 08742) |
Enumeration Date | 2019-01-14 |
Last Update Date | 2023-11-09 |