Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | A115475 | CA |
NPI | 1316123383 |
---|---|
Provider Name | Abnet Amsalework Alemu |
First Address | Antioch, CA 94506 |
Second Address | Antioch, CA 94506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2008 |
Last Update Date | 07/05/2013 |