| NPI | 1912255191 |
|---|---|
| Former Name | BRIANNA NICOLE LAFAYETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA157978) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22382) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |