Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1944 | NM |
NPI | 1013370493 |
---|---|
Provider Name | Andrew Langfitt |
First Address | Albuquerque, NM 87111-2712 |
Second Address | Hobbs, NM 88240-2415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 01/04/2016 |