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 |