| NPI | 1588817944 |
|---|---|
| Former Name | JULIANA ROBERTS MOGIELNICKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: OR PA154104) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA60058289) |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2012-06-12 |