| NPI | 1467962720 |
|---|---|
| Former Name | JULIANA MICHELLE BOUTIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01466) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA6293) |
| Enumeration Date | 2017-10-01 |
| Last Update Date | 2025-10-08 |