Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD2009-0169 | NM |
NPI | 1013056001 |
---|---|
Provider Name | Jennifer M Garcia |
First Address | Albuquerque, NM 87105-4592 |
Second Address | Albuquerque, NM 87105-4592 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 19/12/2011 |