| NPI | 1063569879 |
|---|---|
| Former Name | STACEY LYNN BRAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 009855) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 51684) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2019-08-06 |