NPI | 1366683849 |
---|---|
Former Name | OLYMPIA C VEGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2376) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 12649859-1206) |
Enumeration Date | 2009-03-13 |
Last Update Date | 2023-08-31 |