Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 20A18088 | CA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101021846 | MI |
NPI | 1407238835 |
---|---|
Provider Name | Anwuli Alexandra Anyah |
First Address | Sacramento, CA 95865-5228 |
Second Address | Modesto, CA 95355-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 22/07/2020 |