NPI | 1609475326 |
---|---|
Former Name | REBECCA A WHEALEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00632900) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00632900) |
363AS0400X Physician Assistant, Surgical (Licence: NY 029680) | |
363A00000X Physician Assistant (Licence: NY 029680) | |
Enumeration Date | 2020-10-23 |
Last Update Date | 2025-09-16 |