NPI | 1760546261 |
---|---|
Former Name | BRITTANY AULD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085002914) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085002914) |
Enumeration Date | 2006-12-20 |
Last Update Date | 2018-08-14 |