NPI | 1699273532 |
---|---|
Former Name | MARLENE RODRIGUEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111302) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9111302) |
363A00000X Physician Assistant | |
Enumeration Date | 2018-01-25 |
Last Update Date | 2025-10-02 |