NPI | 1538420922 |
---|---|
Former Name | RACHEL BROOKE HEINLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003902) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2012-06-02 |
Last Update Date | 2019-10-14 |