| NPI | 1891230959 |
|---|---|
| Former Name | JULIANNE FULLMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7927) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10191082-1206) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2023-11-21 |