| NPI | 1699708131 |
|---|---|
| Other Name | G BRAD GREAVES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA615) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID PA615) |
| 363A00000X Physician Assistant (Licence: CA 16369) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-02-02 |