Individual
ALFREDO JOSE MENA LORA
Active
Individual
ALFREDO JOSE MENA LORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036129801
IL
208600000X
Surgery Physician
036129081
IL
390200000X
Student in an Organized Health Care Education/Training Program
125056547
IL
Other
Enumeration date
06/22/2009
Last updated
07/20/2021
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