| NPI | 1023251410 |
|---|---|
| Former Name | BRANDIE DEANN BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX P6111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0031982) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2022-03-04 |