NPI | 1225397706 |
---|---|
Former Name | MARIA D MARTINEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 085004321) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004321) |
Enumeration Date | 2012-05-03 |
Last Update Date | 2024-06-26 |