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 |