NPI | 1609348044 |
---|---|
Former Name | ALLIZ NEREYDA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111715) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2018-12-26 |
Last Update Date | 2021-12-20 |