Mario Moreno, ANP Valid NPI

Individual provider · Family Medicine Physician · Douglas, AZ

NPI

1720042385

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

0505526 (AZ)

Sex

Male

Sole proprietor

No

Enumerated

2006-04-12

Last updated

2013-06-12