| NPI | 1376597658 |
|---|---|
| Former Name | SANDRA A OTERO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601002332) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 765) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2009-06-18 |