Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | E-1611 | AR |
NPI | 1073522181 |
---|---|
Provider Name | Dr. Jorge Antonio Brito |
First Address | Little Rock, AR 72211-3246 |
Second Address | Little Rock, AR 72205-5446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 08/07/2007 |