| NPI | 1104239417 |
|---|---|
| Former Name | JUSTINE MARIE FOSTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056874) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA004260) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-07-30 |