| NPI | 1780910877 |
|---|---|
| Former Name | ANDREA YVONNE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0002909) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0002909) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2019-12-19 |