NPI | 1588303010 |
---|---|
Former Name | BRITTAN AMANDA RIESBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 112989) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2756) |
Enumeration Date | 2022-06-02 |
Last Update Date | 2024-07-17 |