NPI | 1780356642 |
---|---|
Former Name | JULIA MAE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-1029) |
Enumeration Date | 2021-09-29 |
Last Update Date | 2023-01-27 |