| NPI | 1093852113 |
|---|---|
| Other Name | TEODORO MEDINA MONTANO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN 793) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 14489) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2017-12-08 |