NPI | 1144761008 |
---|---|
Former Name | ERNESTO ARTEAGA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9244951) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9244951) |
Enumeration Date | 2017-03-12 |
Last Update Date | 2017-03-12 |