| 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 |