Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 11913 | PR |
NPI | 1457340119 |
---|---|
Provider Name | Eduardo Antonio Pascual |
First Address | San Juan, PR 00926 |
Second Address | Manati, PR 00674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H84722 | (02) |