Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 006858 | GA |
NPI | 1639404346 |
---|---|
Provider Name | Dr. Josue J Andino-Aquino |
First Address | Atlanta, GA 30308-2366 |
Second Address | Atlanta, GA 30308-2366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2009 |
Last Update Date | 14/10/2009 |