NPI | 1164191300 |
---|---|
Former Name | REBECCA MICHELLE MOHNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1796) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-09-10 |
Last Update Date | 2021-10-26 |