Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 5064 | PR |
NPI | 1104987437 |
---|---|
Provider Name | Dr. Pablo M Lopez-Baez |
First Address | Bayamon, PR 00959 |
Second Address | Bayamon, PR 00959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |