| NPI | 1255421954 |
|---|---|
| Former Name | BRYN LEANN MAYBERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN PA1436) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA1436) |
| 363AM0700X Physician Assistant, Medical (Licence: TN PA1436) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-01-26 |