NPI | 1003354507 |
---|---|
Former Name | LINDSEY MARIE BRADSHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10002209A) |
Enumeration Date | 2017-02-03 |
Last Update Date | 2024-11-05 |