| NPI | 1881868644 |
|---|---|
| Former Name | REBECCA LYNN CUPP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2197) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2025-05-21 |