NPI | 1396475174 |
---|---|
Other Name | LANDAN MICHAEL BROOKS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4474) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-14 |
Last Update Date | 2024-10-07 |