| NPI | 1649538828 |
|---|---|
| Former Name | OCTAVIO AVILA ZAMORA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME123042) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10043361) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2015-07-21 |