| NPI | 1306595525 |
|---|---|
| Former Name | DEBORAH JOANNE BRUNDAGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 74625) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 32498) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2023-07-12 |