NPI | 1215321450 |
---|---|
Former Name | BRANDI RAE ROBINSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 81377) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-03-25 |
Last Update Date | 2018-09-27 |