Individual
GABRIELA JANA PRUTSKY LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
268017
MA
208000000X
Pediatrics Physician
Primary
63568
MN
Other
Enumeration date
04/09/2013
Last updated
09/18/2020
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