| NPI | 1982982161 |
|---|---|
| Former Name | DANIELLE NICOLE DEAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0707) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200546) |
| 363A00000X Physician Assistant | |
| 363A00000X Physician Assistant (Licence: UT 9364216-1206) | |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2023-12-26 |