Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 10805 | PR |
NPI | 1033212378 |
---|---|
Provider Name | Jorge E Ruiz Roman |
First Address | San Juan, PR 00919-4000 |
Second Address | Rio Piedras, PR 00921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |