| NPI | 1558763037 |
|---|---|
| Former Name | BRENDA ANN NUNN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA174984) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 1128895) |
| 363A00000X Physician Assistant (Licence: OR PA174984) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2020-04-10 |