Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | 8923 | PR |
NPI | 1023693199 |
---|---|
Provider Name | Gretchen Marie Ramirez Millan |
First Address | Patillas, PR 00723-0697 |
Second Address | Patillas, PR 00723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2021 |
Last Update Date | 10/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00227213 | REGISTRY NUMBER (01) | PR |