| NPI | 1073988291 |
|---|---|
| Former Name | REBECCA LYNN SHUKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061858) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1577) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2022-03-02 |