| NPI | 1811407109 |
|---|---|
| Former Name | BROOKE LORRAINE CONLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA B2084708) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2017-10-02 |