| NPI | 1053908863 |
|---|---|
| Former Name | JOSE L CORRALES ROMERO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95016937) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95045071) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2021-03-19 |