| NPI | 1740683069 |
|---|---|
| Other Name | MOISES ROMEO FAJARDO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704267838) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704267838) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2020-10-22 |