NPI | 1386197317 |
---|---|
Former Name | BROOKE BAILEY SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53385) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 53385) |
Enumeration Date | 2016-07-26 |
Last Update Date | 2023-07-06 |