Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | MD2019-0600 | NM |
NPI | 1184033979 |
---|---|
Provider Name | Dr. Gloria Isabel Lopez-Hernandez |
First Address | Albuquerque, NM 87106-4375 |
Second Address | Albuquerque, NM 87106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2014 |
Last Update Date | 29/07/2019 |