| NPI | 1366614737 | 
|---|---|
| Former Name | NOMIGLY SEPULVEDA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117988)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052670)  | 
| 363AM0700X Physician Assistant, Medical (Licence: SC 3136)  | |
| Enumeration Date | 2008-03-26 | 
| Last Update Date | 2023-12-15 |