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NPI Profile for BERNADINE BACA in ESPAÑOLA, NM.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
1041S0200X |
| NPI # | 1588085500 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/17/2013 | |
| Last updated | 12/17/2013 - About 12 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BERNADINE BACA
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BERNADINE BACA