NPI | 1982157301 |
---|---|
Former Name | REBEKAH MICHELLE HALLERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: UT 9847199-1206) |
Enumeration Date | 2016-08-02 |
Last Update Date | 2019-09-16 |