| NPI | 1407237522 |
|---|---|
| Former Name | NICOLE ANN AMEZQUITA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GU PA-109) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-10-13 |