NPI | 1285083212 |
---|---|
Former Name | KAITLIN M BRUBAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004194) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059147) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2023-08-15 |