NPI | 1396088514 |
---|---|
Former Name | REBECCA ASHLEY HERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2013-04-05 |
Last Update Date | 2015-09-10 |