NPI | 1336459262 |
---|---|
Former Name | BRANDY MICHELLE CLOUSER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105699) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105699) |
Enumeration Date | 2010-10-13 |
Last Update Date | 2024-07-17 |