| NPI | 1063751923 |
|---|---|
| Former Name | SELENA MARIE ZAMORA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113486) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA4624) |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 3058) | |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2022-08-09 |