NPI | 1770035172 |
---|---|
Former Name | BRANDI SAUCERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: 142817) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2016-11-01 |
Last Update Date | 2022-01-19 |