Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 1965 | CA |
NPI | 1073894218 |
---|---|
Provider Name | Caitlin Miller |
First Address | Davis, CA 95616-9701 |
Second Address | Davis, CA 95616-9701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2011 |
Last Update Date | 01/09/2011 |