Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0110005629 | VA |
NPI | 1043732316 |
---|---|
Provider Name | Brandee Leigh Winkler |
First Address | Virginia Beach, VA 23454-4424 |
Second Address | Suffolk, VA 23435-2663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2017 |
Last Update Date | 08/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0110005829 | (05) | VA |