Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service |
NPI | 1497104152 |
---|---|
Provider Name | Ana Isabel Rodriguez |
First Address | Pahrump, NV 89061-9027 |
Second Address | Pahrump, NV 89061-9027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2016 |
Last Update Date | 03/06/2016 |