NPI | 1912486531 |
---|---|
Former Name | RACHAEL MARIE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4486-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4486-23) |
Enumeration Date | 2018-08-14 |
Last Update Date | 2020-04-28 |