NPI | 1538596077 |
---|---|
Former Name | REBECCA D SHEEHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9252) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 9252) |
363AM0700X Physician Assistant, Medical (Licence: PA MA058852) | |
363AM0700X Physician Assistant, Medical (Licence: VA 0110004373) | |
Enumeration Date | 2013-09-30 |
Last Update Date | 2019-08-05 |