Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 2000-260 | NM |
NPI | 1124213582 |
---|---|
Provider Name | Dr. Sunil Tonse Pai |
First Address | Albuquerque, NM 87109-6020 |
Second Address | Albuquerque, NM 87109-6020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 10/09/2007 |