| NPI | 1558846063 | 
|---|---|
| Former Name | ALFREDO CORTEZ | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 4485) | 
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-10-01 | 
| Last Update Date | 2024-06-19 |