NPI | 1790874188 |
---|---|
Former Name | JANET L. BRUNNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 565) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA001978L) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2018-03-17 |