| NPI | 1881905263 |
|---|---|
| Former Name | EMILY R JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009118) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0110009118) |
| 363A00000X Physician Assistant (Licence: WI 2623-23) | |
| 363A00000X Physician Assistant (Licence: MN 10955) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2023-09-11 |