Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 230169 | PR |
NPI | 1407019318 |
---|---|
Provider Name | Uzkelia Uzcategui Moncada |
First Address | San Juan, PR 00922-2116 |
Second Address | San Juan, PR 00922-2116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |