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Individual

MR. LUIS ROSENDO LARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-6597
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN555329
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN555329
PA

Other

Enumeration date
03/31/2012
Last updated
09/26/2023
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