NPI | 1588960397 |
---|---|
Former Name | CANDACE BROOKE BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC356) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
Enumeration Date | 2011-01-27 |
Last Update Date | 2023-11-27 |