| NPI | 1386970762 |
|---|---|
| Former Name | RACHEL ANN BOURNAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005676) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001490A) |
| 363A00000X Physician Assistant (Licence: IN 99055192A) | |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10001490A) | |
| 363AS0400X Physician Assistant, Surgical (Licence: MI 5601005676) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2022-03-09 |