| NPI | 1457689143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY SIEBER Credentialing Specialist 916-733-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19332) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |