NPI | 1821188269 |
---|---|
Former Name | LETY ELIZABETH AMAYA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME158393) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA17517) |
363A00000X Physician Assistant (Licence: NE 680) | |
363LF0000X Nurse Practitioner, Family (Licence: NE 110879) | |
Enumeration Date | 2006-10-14 |
Last Update Date | 2022-08-15 |