Individual
LARIZA ROSAS VALDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 WILLIAM ST SE, ALBUQUERQUE, NM 87102-4661
(505) 768-5450
Mailing address
1401 WILLIAM ST SE, ALBUQUERQUE, NM 87102-4661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA2017-0072
NM
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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