NPI | 1114519428 |
---|---|
Former Name | BRITTANY KIERRA THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11203) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC MPA.3831.PA) |
Enumeration Date | 2021-02-08 |
Last Update Date | 2024-10-28 |