| NPI | 1790996239 |
|---|---|
| Former Name | BRANDY M STATHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P1811) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P1811) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-07-08 |