| NPI | 1942793005 |
|---|---|
| Former Name | REBECCA ELAINE TATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 33366) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 010088) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-06-10 |