Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 29,081-R | PR |
NPI | 1003161407 |
---|---|
Provider Name | Deborah Corinne Parish |
First Address | Quebradillas, PR 00678-9496 |
Second Address | Quebradillas, PR 00678-9496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2012 |
Last Update Date | 23/07/2012 |