NPI | 1285265504 |
---|---|
Former Name | CASSANDRA ALYSE RIVERA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13502) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
Enumeration Date | 2020-01-27 |
Last Update Date | 2023-03-21 |