| NPI | 1205107687 |
|---|---|
| Former Name | BRANDY CAROL HASTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2012009152) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2019-12-30 |