| NPI | 1770547580 |
|---|---|
| Former Name | BRANDY LYNN CRUSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 104058) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 000104058) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2021-10-20 |