| NPI | 1417478504 | 
|---|---|
| Former Name | RACHEL MICHELLE BRADFORD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005812)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110-005812)  | 
| Enumeration Date | 2017-06-29 | 
| Last Update Date | 2022-04-28 |