| NPI | 1992141337 |
|---|---|
| Former Name | MEREDITH REBEKAH BANKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: GA 6814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006814) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2021-01-07 |