| NPI | 1417055914 |
|---|---|
| Former Name | AMELIA KATHLEEN VAZQUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 000419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000419) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-08-18 |