Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 14992 | PR |
NPI | 1295780765 |
---|---|
Provider Name | Dr. Rafael Ongay Rullan |
First Address | Utuado, PR 00641-2902 |
Second Address | Utuado, PR 00641-2902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/07/2007 |