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Individual
VICENTE GABRIEL MONTEIRO MENDES
Active
Individual
VICENTE GABRIEL MONTEIRO MENDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
1710I1002X
Independent Duty Corpsman
—
—
363A00000X
Physician Assistant
Primary
PA57011
CA
Other
Enumeration date
11/03/2011
Last updated
07/12/2019
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