NPI | 1689156747 |
---|---|
Former Name | BRISLYN SIZEMORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14445) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA23874) |
Enumeration Date | 2018-09-05 |
Last Update Date | 2024-08-14 |