| NPI | 1295766780 |
|---|---|
| Former Name | JULIA E GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MS PA00246) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006517) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 0110001737) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-07-20 |