Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 5652 | PR |
NPI | 1265406128 |
---|---|
Provider Name | Dr. Enrique Segura Nieves |
First Address | Bayamon, PR 00960-5688 |
Second Address | Bayamon, PR 00961-7019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 24/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F09051 | (02) | PR |