NPI | 1104825579 |
---|---|
Former Name | REBECCA LYNN CASTAGNA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C50000290) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C50000290) |
Enumeration Date | 2005-07-19 |
Last Update Date | 2007-07-08 |