NPI | 1053693580 |
---|---|
Professional Name | JUAN CARLOS CANTU GALAVIZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN673) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 18320) |
Enumeration Date | 2011-09-11 |
Last Update Date | 2024-10-31 |