NPI | 1174630180 |
---|---|
Former Name | LEANNE R. BREIHAHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 170876) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 36234) |
363A00000X Physician Assistant (Licence: TN PA0000001325) | |
Enumeration Date | 2006-08-24 |
Last Update Date | 2021-06-17 |