NPI | 1114205572 |
---|---|
Former Name | LAURA ESPERANZA PENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001310A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99048212A) |
Enumeration Date | 2011-08-02 |
Last Update Date | 2024-11-06 |