Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD2018-0865 | NM |
N | 111NI0900X | Internist | MD2018-0865 | NM |
Y | 207RX0202X | Medical Oncology | MD2018-0865 | NM |
NPI | 1063776086 |
---|---|
Provider Name | Sofia Palacio Cardenas |
First Address | Albuquerque, NM 87109 |
Second Address | Albuquerque, NM 87109-4495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
99978385 | (05) | NM |