NPI | 1912216722 |
---|---|
Former Name | JULIE M GAYDASH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05322) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0004339) |
Enumeration Date | 2010-09-28 |
Last Update Date | 2021-02-24 |