Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 306105 | NY |
NPI | 1023363397 |
---|---|
Provider Name | Oliver Pulido |
First Address | Minnetonka, MN 55343-9664 |
Second Address | New York, NY 10119-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2012 |
Last Update Date | 26/06/2020 |