Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 3857 | PR |
NPI | 1033192380 |
---|---|
Provider Name | Trevor Hope Grant |
First Address | San Juan, PR 00912-3301 |
Second Address | San Juan, PR 00936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C77267 | (02) | PR |