Individual
WILDALYS ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 AVENIDA DR, SUSONI, HATILLO, PR 00659
(787) 898-4190
Mailing address
16 AVENIDA DR. SUSONI, HATILLO, PR 00659
(787) 898-4190
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
8695
PR
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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