NPI | 1669714366 |
---|---|
Former Name | BRANDI ELIZABETH BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 207700) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-03-20 |
Last Update Date | 2019-10-29 |