| NPI | 1780365791 |
|---|---|
| Former Name | REBEKA A RAVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2903) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-10-25 |