| NPI | 1932762309 |
|---|---|
| Former Name | DANIEL LOPEZ INFANTE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 21466) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14888-I) |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2021-03-11 |