| NPI | 1285336867 |
|---|---|
| Former Name | CARLOS GENARO VELARDE GONZALES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD70013782) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA ML61426209) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2025-09-09 |