| NPI | 1740662352 |
|---|---|
| Former Name | BRITTNY NICOLE GUDALIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 1906) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2019-01-31 |