NPI | 1700254125 |
---|---|
Former Name | ABIGAEL BRENNAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4399) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0004381) |
Enumeration Date | 2015-09-02 |
Last Update Date | 2021-01-20 |