NPI | 1982052130 |
---|---|
Former Name | REBEKAH FRAZIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME144152) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 267382) |
Enumeration Date | 2016-05-27 |
Last Update Date | 2023-06-15 |