| NPI | 1679028039 |
|---|---|
| Former Name | BRINA MACKENZIE LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60694991) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 1134215) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2019-10-01 |