NPI | 1124361977 |
---|---|
Former Name | AMBER LYNN RUBAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OT015059) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-03-30 |
Last Update Date | 2013-11-08 |