| NPI | 1962787044 |
|---|---|
| Former Name | BRITTANY L BANIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004202) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 10001349A) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2015-07-06 |