NPI | 1174936124 |
---|---|
Former Name | REBECCA MARIE RAUB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 53211) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74644) |
Enumeration Date | 2014-06-07 |
Last Update Date | 2019-03-25 |