Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15396-I | PR |
NPI | 1043822778 |
---|---|
Provider Name | Dr. Lauren Lau Angarita |
First Address | Toa Alta, PR 00953-2449 |
Second Address | Manati, PR 00674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2020 |
Last Update Date | 24/08/2020 |