| NPI | 1679723605 |
|---|---|
| Former Name | DONNA LIANNE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0008661) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002867) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2023-06-07 |