| NPI | 1770711459 |
|---|---|
| Former Name | DANIELLE LEENORA KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD c0003980) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030597) |
| 363A00000X Physician Assistant (Licence: CA PA21525) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2013-01-09 |