Individual
MAIRA ALFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8807 FAIRBANKS RD NE, ALBUQUERQUE, NM 87112-1229
(505) 288-9762
Mailing address
8807 FAIRBANKS RD NE, ALBUQUERQUE, NM 87112-1229
(505) 288-9762
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
03-132327-00-8
NM
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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