NPI | 1164048674 |
---|---|
Former Name | REBECCA LYNN COURT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010041) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-06-20 |
Last Update Date | 2022-10-18 |