| NPI | 1487960209 |
|---|---|
| Former Name | JANELLE NICHOLE GOODREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10772) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-05267) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2022-03-03 |