Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1740360940 |
---|---|
Provider Name | Celia Dawn Delozier |
First Address | Fresno, CA 93727-1560 |
Second Address | Fresno, CA 93721-1439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 30/11/2011 |