NPI | 1659049120 |
---|---|
Former Name | REBEKAH NICOLE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA005812) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062836) |
Enumeration Date | 2021-08-31 |
Last Update Date | 2023-12-22 |