Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 33 | PR |
Y | 103TC0700X | Clinical Psychologist | 33 | PR |
NPI | 1013128107 |
---|---|
Provider Name | Dr. Jose J Bauermeister |
First Address | San Juan, PR 00927-4230 |
Second Address | San Juan, PR 00927-4230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |