NPI | 1346756301 |
---|---|
Former Name | BRITTANY BAGLOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17504) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 55266) |
207X00000X Orthopaedic Surgery (Licence: MA PA6284) | |
Enumeration Date | 2017-12-28 |
Last Update Date | 2024-10-08 |