Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 891 | PR |
NPI | 1083026850 |
---|---|
Provider Name | Yamira Garcia |
First Address | San Juan, PR 00917 |
Second Address | San Juan, PR 00917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2014 |
Last Update Date | 28/05/2014 |