NPI | 1578019717 |
---|---|
Former Name | JULIE WIKIERA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3550) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004740RX) |
Enumeration Date | 2016-08-28 |
Last Update Date | 2021-08-25 |