| NPI | 1538773742 |
|---|---|
| Former Name | JOSE ALBERTO NUNEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |