WAGNER GERVAIS

SAN JUAN, PR
NPI1518596295
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207QA0000X Family Medicine, Adolescent Medicine
(Licence: PR  258-PA)
Enumeration Date2020-04-05
Last Update Date2020-04-05
Business Address
WAGNER GERVAIS
151 CALLE LAS LOMAS
SAN JUAN, PR 00926-5527
Phone number: 956-578-6712
Mailing Address
WAGNER GERVAIS
151 CALLE LAS LOMAS
SAN JUAN, PR 00926-5527
Phone number: