| NPI | 1851735708 |
|---|---|
| Former Name | BRIELLE KIMBERLY PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: LA 320622) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2013-0323) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2019-10-02 |