NPI | 1578399663 |
---|---|
Former Name | BRIANNA MORGAN JOHNSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA OA007136) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical (Licence: PA MA066262) | |
Enumeration Date | 2024-09-13 |
Last Update Date | 2024-12-16 |