| NPI | 1952392250 |
|---|---|
| Former Name | WANDA MARIE GUTIERREZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 6560146-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 16176) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP12817) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2024-12-08 |