| NPI | 1174755763 | 
|---|---|
| Former Name | RACHELLE CONCEPCION | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60123) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015764) | 
| Enumeration Date | 2009-08-14 | 
| Last Update Date | 2022-11-28 |