Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 2020 | PR |
NPI | 1568677201 |
---|---|
Provider Name | Dr. Waleska Socorro Pabon |
First Address | Guayama, PR 00784-6408 |
Second Address | Guayama, PR 00784-6408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065162 | CRUZ AZUL (01) | PR |
21124 | TRIPLESS (01) | PR |