Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist |
NPI | 1891176483 |
---|---|
Provider Name | Michael Tapia |
First Address | Bernalillo, NM 87004-5909 |
Second Address | Raton, NM 87740-4366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 09/06/2015 |