NPI | 1831580802 |
---|---|
Former Name | BRITNEY MARIE POPP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108476) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108476) |
Enumeration Date | 2015-02-12 |
Last Update Date | 2023-04-24 |