| NPI | 1629156609 |
|---|---|
| Former Name | BREEANNA S VANCOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA01175) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005104) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-05-04 |