| NPI | 1295308591 |
|---|---|
| Former Name | BRIANNA LYNN WITTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13020) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008673) |
| 363A00000X Physician Assistant (Licence: WI 5691-23) | |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2024-03-27 |