NPI | 1013153816 |
---|---|
Former Name | JULIE MASON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06813) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001058A) |
363A00000X Physician Assistant (Licence: IN 99033970A) | |
Enumeration Date | 2008-12-29 |
Last Update Date | 2022-07-21 |