| NPI | 1093334245 |
|---|---|
| Former Name | DANIELLE JUSTINE ORTEGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA57950) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12511) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2022-10-06 |