| NPI | 1437121712 |
|---|---|
| Former Name | JULIA LYNNE CHICKEDANTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10000508A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000508A) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2024-02-05 |