Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1025408 | TX |
NPI | 1447848254 |
---|---|
Provider Name | Rodolfo Luna |
First Address | San Antonio, TX 78229-3902 |
Second Address | San Antonio, TX 78229-3902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2021 |
Last Update Date | 07/01/2021 |