| NPI | 1114369576 |
|---|---|
| Former Name | JOANNA GLORIA SANFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7117) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2019-02-11 |