NPI | 1104351097 |
---|---|
Former Name | VICTORIA BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 54861) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-04-27 |
Last Update Date | 2021-11-18 |