Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1154660660 |
---|---|
Provider Name | Monica Larrea De Arellano |
First Address | Ribera, NM 87560-0265 |
Second Address | Ribera, NM 87560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2013 |
Last Update Date | 17/03/2018 |