| NPI | 1295109478 |
|---|---|
| Former Name | EMILY JEAN BOARDMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1010) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 079778) |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2016-08-17 |