NPI | 1396934352 |
---|---|
Former Name | BREANNE M MURGALLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053175) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA053175) |
Enumeration Date | 2007-10-16 |
Last Update Date | 2020-07-30 |