NPI | 1184876492 |
---|---|
Former Name | VANESSA RENE BREAUX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 1674) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1674) |
Enumeration Date | 2008-10-17 |
Last Update Date | 2021-09-17 |