NPI | 1689649410 |
---|---|
Former Name | JULIE MARIE YOUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL 3638) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA 3638) |
Enumeration Date | 2006-02-23 |
Last Update Date | 2009-02-09 |