NPI | 1932430741 |
---|---|
Former Name | LISA M BAEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1794) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 1794) |
363AS0400X Physician Assistant, Surgical (Licence: TN 1794) | |
Enumeration Date | 2010-01-18 |
Last Update Date | 2023-06-29 |