Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | K1605 | TX |
NPI | 1053355735 |
---|---|
Provider Name | Dr. Joseph Agage Ouma |
First Address | Albuquerque, NM 87117 |
Second Address | Albuquerque, NM 87117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 06/07/2018 |