Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | CNP-01672 | NM |
N | 363L00000X | Nurse Practitioner | CNP-01672 | NM |
NPI | 1396047957 |
---|---|
Provider Name | Mr. Porfinio James Romero |
First Address | Albuquerque, NM 87110-1524 |
Second Address | Albuquerque, NM 87110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2010 |
Last Update Date | 06/09/2018 |