| NPI | 1922998756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL RODRIGUEZ LORA Owner 346-573-5605 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-03 |
| Last Update Date | 2025-08-01 |