| NPI | 1477185171 |
|---|---|
| Former Name | MARISSA KATE BREIDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2022-02-16 |