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Individual
MR. MARIO BAUTISTA SY
Active
Individual
MR. MARIO BAUTISTA SY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
34978
IA
207RH0003X
Hematology & Oncology Physician
Primary
34978
IA
Other
Enumeration date
03/23/2006
Last updated
12/14/2012
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