NPI | 1124353693 |
---|---|
Former Name | BRIANNA E HENRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60913223) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR 153165) |
Enumeration Date | 2009-10-16 |
Last Update Date | 2020-12-06 |