NPI | 1467235192 |
---|---|
Former Name | BRITTANY K POOLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 14029242-1206) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 14029242-1206) |
Enumeration Date | 2023-08-16 |
Last Update Date | 2025-01-27 |