| NPI | 1720593775 |
|---|---|
| Former Name | REBECCA ANN GOVERNALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60805138) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60805138) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2021-11-04 |