Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 001 | PR |
NPI | 1073639787 |
---|---|
Provider Name | Efrain Rodriguez |
First Address | San Juan, PR 00924 |
Second Address | San Juan, PR 00924 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |