NPI | 1700525664 |
---|---|
Former Name | BROOKLYN LEE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX BP10078445) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX V9436) |
Enumeration Date | 2022-05-31 |
Last Update Date | 2025-06-18 |