| NPI | 1275867640 |
|---|---|
| Former Name | ALEXIS JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2025-03-06 |