| NPI | 1154738672 |
|---|---|
| Former Name | GABRIELLE JOHNSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4007) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07028) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2022-01-20 |