| NPI | 1649923806 |
|---|---|
| Former Name | BAILIEGH REBEKAH LANGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA15291) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA15291) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-04-04 |