| NPI | 1710129473 |
|---|---|
| Former Name | BREANNA MARIE SUMMERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO202589) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0049522) |
| 208000000X Pediatrics (Licence: OR DO202589) | |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2025-01-02 |