NPI | 1588210330 |
---|---|
Former Name | BRANDI M HORNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177836) |
Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0024177836) |
Enumeration Date | 2019-08-16 |
Last Update Date | 2023-12-13 |