NPI | 1386089241 |
---|---|
Former Name | ELIZABETH RODRIGUEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 005328) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-05-06 |
Last Update Date | 2022-02-11 |