Mario Bouchard
NPI #1104350859 in Gallup, New Mexico
Provider Information
- NPI Number
- 1104350859
- Entity Type
- Individual
- Name
- Mario Bouchard
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Registered Nurse - Critical Care Medicine
- Enumeration Date
- Apr 19, 2017
- Last Updated
- Apr 19, 2017
Practice Location
- Address
- 516 E NIZHONI BLVD
- City
- Gallup
- State
- New Mexico
- ZIP Code
- 87301-5748
- Phone
- (505) 722-1000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse - Critical Care Medicine — Critical Care Medicine |
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