| NPI | 1427599695 |
|---|---|
| Former Name | ANGEL LUIS ORTIZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 022514) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2021-10-12 |