| NPI | 1366068256 |
|---|---|
| Former Name | REBEKAH DANIELLE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115144) |
| 363A00000X Physician Assistant (Licence: KY PA2883) | |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2023-04-26 |