| NPI | 1225677149 |
|---|---|
| Former Name | JULIA NICOLE BACAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13442) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2024-12-07 |