| NPI | 1164824306 |
|---|---|
| Former Name | REBECCA LENOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2016-03-15 |