| NPI | 1902166705 |
|---|---|
| Former Name | REBECCA NICOLE JANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD171980) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2016-01-27 |