| NPI | 1023667862 |
|---|---|
| Former Name | WALDO MARIO VAZQUEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 234060) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: AZ 234060) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: AZ 234060) | |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2020-05-11 |