| NPI | 1649637976 |
|---|---|
| Former Name | LIBIN MANUEL ZEVALLOS QUINONEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.022777) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.473317) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238.000480) | |
| Enumeration Date | 2016-01-17 |
| Last Update Date | 2021-01-29 |