Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 1842 | PR |
NPI | 1073733168 |
---|---|
Provider Name | Dr. Manuel E Hernandez Duprey |
First Address | Arecibo, PR 00614 |
Second Address | Arecibo, PR 00612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
41824 | SSS (01) | PR |