NPI | 1114209145 |
---|---|
Former Name | JULIE THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0946) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4247) |
363A00000X Physician Assistant (Licence: ME PA001305) | |
Enumeration Date | 2011-09-15 |
Last Update Date | 2018-03-01 |