NPI | 1316295504 |
---|---|
Former Name | LEIGH S. BREWSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002981) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015762) |
363A00000X Physician Assistant | |
363A00000X Physician Assistant (Licence: VA 0110005268) | |
Enumeration Date | 2012-08-21 |
Last Update Date | 2023-06-02 |