| NPI | 1942762760 |
|---|---|
| Former Name | BREANNA MARIE TRISKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: VA 0101270390) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101270390) |
| 207L00000X Anesthesiology (Licence: VA 0101270390) | |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2026-07-30 |