NPI | 1215921838 |
---|---|
Former Name | BROOKE ELIZABETH HALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 545) |
Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 3094) |
Enumeration Date | 2005-09-09 |
Last Update Date | 2011-12-19 |