| NPI | 1467590158 |
|---|---|
| Professional Name | AUGUSTINE QUINONES PROVENCIO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A48099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 36333) |
| 207Q00000X Family Medicine (Licence: AK 3673) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2022-03-23 |