NPI | 1730149063 |
---|---|
Former Name | MARIA REGINA LACOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA050653) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA050653) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2011-08-31 |