| NPI | 1225213200 |
|---|---|
| Former Name | AUDREY C SEVILLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9108569) |
| 363AS0400X Physician Assistant, Surgical (Licence: GU PA-070) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2023-04-13 |