Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 8100 | PR |
NPI | 1003806324 |
---|---|
Provider Name | Dr. Kiyomi M Santos Onoda |
First Address | Ponce, PR 00732-0730 |
Second Address | Penuelas, PR 00624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 30/06/2010 |