| NPI | 1780616474 |
|---|---|
| Former Name | RACHEL ANN PTAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2013-0081) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2013-0081) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-09-08 |