NPI | 1245821586 |
---|---|
Former Name | AMY JANINA FERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001012194) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4226) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-01-29 |
Last Update Date | 2025-03-19 |