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1235710039
ERICK LARIOS BAUTISTA
NUTLEY, NJ
NPI
1235710039
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-14
Last Update Date
2021-04-14
Business Address
ERICK LARIOS BAUTISTA
340 KINGSLAND ST
NUTLEY, NJ 07110-1150
Phone number: 973-542-6678
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Mailing Address
ERICK LARIOS BAUTISTA
340 KINGSLAND ST
NUTLEY, NJ 07110-1150
Phone number: 973-542-6678
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