NPI | 1194026815 |
---|---|
Former Name | HARMONY RAE BROGDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA760) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MS PA00139) |
Enumeration Date | 2010-11-11 |
Last Update Date | 2021-08-19 |