NPI | 1972837185 |
---|---|
Former Name | JOHNNA L BOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1551) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4281) |
Enumeration Date | 2009-09-22 |
Last Update Date | 2013-08-29 |