NPI | 1639662349 |
---|---|
Former Name | REBECCA ANN FOBAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345861) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704289501) |
Enumeration Date | 2018-06-08 |
Last Update Date | 2020-08-03 |