Individual
GABRIEL GOVENDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1622 GALISTEO ST, SANTA FE, NM 87505-4747
(510) 290-4456
Mailing address
PO BOX 7, WOODVILLE, MA 01784-0007
(510) 290-4456
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2015
Last updated
04/29/2015
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