Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 2490 | PR |
NPI | 1215902234 |
---|---|
Provider Name | Dr. Robert Cacho |
First Address | San Juan, PR 00927-6551 |
Second Address | San Juan, PR 00911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 08/07/2007 |