NPI | 1447603055 |
---|---|
Former Name | OCTAVIO SANTIAGO SANTANA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: PR 23252) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MN 70917) |
Enumeration Date | 2016-07-19 |
Last Update Date | 2023-07-18 |