| NPI | 1346729696 |
|---|---|
| Former Name | BROOKLYNNE BRIANA ASHLEY FREDERICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61058272) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2024-02-16 |