NPI | 1205416955 |
---|---|
Former Name | ROLANDO AGUSTIN FLEITES LLANIO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL F03211250) |
Enumeration Date | 2021-04-08 |
Last Update Date | 2021-04-08 |