NPI | 1326237710 |
---|---|
Former Name | REBECCA A CICCONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053211) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053211) |
Enumeration Date | 2007-10-22 |
Last Update Date | 2018-06-01 |