| Street | Amadeo Figueroa | ||
| City/Town | Huaraz | ||
| State/Province/Region | Ancash | ||
| Zip/Postal Code | 02001 | ||
| Phone Number | (043) 422584 | ||
| Country | Peru |
| Full Name | Dr. Rodrigo Roque | ||
| Gender | male | ||
| Birthday | 1996-05-13 | ||
| Social Security Number |
| Credit card brand | Mastercard | ||
| Credit card number | 5463060980400652 | ||
| Expire | 2029/12 | ||
| CVV | 696 |