Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 14953 | AZ |
NPI | 1073776118 |
---|---|
Provider Name | Eduardo Goquiolay Arellano |
First Address | Bluffton, SC 29910-4928 |
Second Address | Bluffton, SC 29910-4928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 09/07/2008 |