| NPI | 1811273113 |
|---|---|
| Former Name | BRANDI NICOLE BAUGHCUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005279RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21974) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2017-11-14 |