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 |