| NPI | 1750508735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INAS ANIS Provider 818-587-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA rn461744 8797) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-08-08 |