| NPI | 1134625676 |
|---|---|
| Former Name | ANGEL MENDOZA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A163700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2022-02-11 |