NPI | 1689449522 |
---|---|
Former Name | BROOKE LAEL TOMPKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7704) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601012169) |
Enumeration Date | 2023-11-21 |
Last Update Date | 2023-11-21 |