| NPI | 1962490177 |
|---|---|
| Former Name | HOLLY A SUNDVALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9102707) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102707) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-09-01 |