| NPI | 1518159870 |
|---|---|
| Former Name | REBECCA L RUNGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: KS 15-01210) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MO 2007028966) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2011-11-28 |