Individual
IRINA GORSHKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
517 E NIZHONI BLVD, GALLUP, NM 87301-5757
(505) 722-6603
Mailing address
517 E NIZHONI BLVD, GALLUP, NM 87301-5757
(505) 722-6603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2022-0114
NM
Other
Enumeration date
02/19/2022
Last updated
12/06/2022
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