| NPI | 1821596073 |
|---|---|
| Former Name | VENICE LUCIA LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY PT904) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 11159450-1206) |
| 363A00000X Physician Assistant (Licence: FL 9110986) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2023-02-28 |