Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 267 | PR |
NPI | 1538297718 |
---|---|
Provider Name | Dr. Cesar A. Irizarry |
First Address | Aguadilla, PR 00603 |
Second Address | Aguadilla, PR 00603-1105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 08/07/2007 |