| NPI | 1770357048 |
|---|---|
| Former Name | BRIANNA MARIE TIPTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 0010-13762) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13762) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-13762) | |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |