| NPI | 1497300099 | 
|---|---|
| Former Name | BLAIRE BROOKS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3489) | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| Enumeration Date | 2019-08-09 | 
| Last Update Date | 2024-12-23 |