NPI | 1659361970 |
---|---|
Former Name | ZOILA REYNA LOPEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA03369) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA03369) |
363AS0400X Physician Assistant, Surgical (Licence: IL 085.002951) | |
363AS0400X Physician Assistant, Surgical (Licence: GA GA005528) | |
Enumeration Date | 2005-10-27 |
Last Update Date | 2014-01-03 |