| NPI | 1174032122 |
|---|---|
| Professional Name | CARLOS EDUARDO BONILLA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5250948-4405) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2018-03-17 |