| NPI | 1679054464 |
|---|---|
| Former Name | STACI LEIGH BRAUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2019-02-21 |