NPI | 1306344221 |
---|---|
Former Name | BRIANNA GOLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16325) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: FL OS16325) |
207Q00000X Family Medicine (Licence: AL DO.3375) | |
Enumeration Date | 2018-01-25 |
Last Update Date | 2024-03-29 |