| NPI | 1255450250 |
|---|---|
| Former Name | JOAN EVE MALCOUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9110284) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003492) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-06-13 |