NPI | 1770045833 |
---|---|
Former Name | ERICA RENAE GUEVARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7596) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61526401) |
363A00000X Physician Assistant (Licence: CO PA.0008420) | |
363A00000X Physician Assistant (Licence: MA PA100449) | |
363A00000X Physician Assistant (Licence: GA 12310) | |
363A00000X Physician Assistant (Licence: NC 0010-14186) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-05 |
Last Update Date | 2024-05-08 |