Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 59 | PR |
NPI | 1104475904 |
---|---|
Provider Name | David Alexander Cruz |
First Address | Cayey, PR 00736 |
Second Address | Cayey, PR 00736-5534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2019 |
Last Update Date | 05/09/2019 |