NPI | 1356571970 |
---|---|
Former Name | BRANDON ELIZABETH DOUGHERTY-HAMOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053927) |
Enumeration Date | 2009-07-16 |
Last Update Date | 2016-12-12 |