Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD2018-0449 | NM |
NPI | 1013259076 |
---|---|
Provider Name | Ms. Lenora Michelle Mathes |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Rio Rancho, NM 87124-4740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2013 |
Last Update Date | 13/01/2022 |