NPI | 1750525531 |
---|---|
Former Name | BRENDA KARINA AYALA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006638) |
Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
Enumeration Date | 2009-04-24 |
Last Update Date | 2024-06-24 |