NPI | 1932545423 |
---|---|
Professional Name | JERRY TREJO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 65347) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 324744) |
Enumeration Date | 2013-05-11 |
Last Update Date | 2024-02-29 |