| NPI | 1710347984 |
|---|---|
| Former Name | BRIGETTE KETRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2016006195) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2020-07-01 |