NPI | 1679854798 |
---|---|
Former Name | TARYN BRIN PERSIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1875) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4224) |
363AM0700X Physician Assistant, Medical (Licence: NH 1875) | |
Enumeration Date | 2011-09-01 |
Last Update Date | 2024-08-22 |