| NPI | 1407119753 |
|---|---|
| Former Name | JULIE MONTGOMERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 006493) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6493) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2021-01-22 |