| NPI | 1316811151 |
|---|---|
| Former Name | PABLO AYALA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11049289) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9637403) |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2026-07-20 |