| NPI | 1972985554 |
|---|---|
| Former Name | BROOKE ELIZABETH KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057682) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2023-07-17 |