NPI | 1528640448 |
---|---|
Other Name | JOSE L AYALA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: PR 23570) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 023570) |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2021-04-21 |
Last Update Date | 2024-09-10 |