| NPI | 1972152593 |
|---|---|
| Former Name | JULIE ANNA WOODSTOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024166) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2024-06-10 |