| NPI | 1134904915 |
|---|---|
| Former Name | CHRISTINE KIMBERLEE MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-12-04 |