Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 18825 | PR |
NPI | 1043627128 |
---|---|
Provider Name | Dr. Jesus G Noguer |
First Address | Bayamon, PR 00961-8559 |
Second Address | Bayamon, PR 00961-8559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 21/07/2014 |