| NPI | 1821618638 |
|---|---|
| Former Name | RODOLFO JR CARSON JARAVATA-HANSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014394) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-08-20 |