Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 11939 | PR |
NPI | 1023063104 |
---|---|
Provider Name | Mr. Gabriel Martinez-Rodriguez |
First Address | Ponce, PR 00734-0239 |
Second Address | Ponce, PR 00780 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 29/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G42761 | (02) |