NPI | 1184821274 |
---|---|
Former Name | REBEKAH C HERTIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01225) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2139-023) |
363AM0700X Physician Assistant, Medical (Licence: WI 2139023) | |
Enumeration Date | 2007-07-02 |
Last Update Date | 2024-09-11 |