Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 17927 | PR |
Y | 111NI0900X | Internist | 17927 | PR |
N | 207RG0100X | Gastroenterologist | 17927 | PR |
NPI | 1033367172 |
---|---|
Provider Name | Dr. Robert Brian Sojo-Altieri |
First Address | Manati, PR 00674-4615 |
Second Address | Manati, PR 00674-4615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 08/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17927 | PERMANENT STATE LICENSE (01) | PR |