Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 7278 | PR |
NPI | 1104887124 |
---|---|
Provider Name | Dr. Enid Rivera - Jimenez |
First Address | Caguas, PR 00726 |
Second Address | Rio Piedras, PR 00921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 14/03/2013 |