| NPI | 1861733313 |
|---|---|
| Former Name | MICHELLE NICOLE VAZQUEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: FL ME153065) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 265109) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2023-11-10 |