| NPI | 1700858206 |
|---|---|
| Former Name | VICTORIA A SPAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0001-03562) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2016-11-04 |