| NPI | 1023578267 |
|---|---|
| Former Name | REBECCA ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 5654) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TN 5654) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-01-29 |