| NPI | 1962026955 |
|---|---|
| Former Name | BRIDGETTE LYNN CAQUATTO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8289) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9118420) |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2024-08-16 |