NPI | 1417911066 |
---|---|
Former Name | REBECCA LYNNE VANDER SLOOT - VANDERMOLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002996) |
Enumeration Date | 2006-04-12 |
Last Update Date | 2022-05-26 |