| NPI | 1528218815 |
|---|---|
| Former Name | BRIELLE MARIE BUCKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07418) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2019-09-25 |