NPI | 1265494926 |
---|---|
Former Name | LISA BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001679) |
Additional Taxonomies | 2471V0106X Radiologic Technologist, Vascular-Interventional Technology (Licence: CT 001679) |
Enumeration Date | 2006-04-06 |
Last Update Date | 2021-08-27 |