Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 9557 | PR |
NPI | 1255487930 |
---|---|
Provider Name | Dr. Aurelio Segundo |
First Address | San Juan, PR 00927-6712 |
Second Address | San Juan, PR 00912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 08/07/2007 |