Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A130966 | CA |
NPI | 1003175746 |
---|---|
Provider Name | Cianna Leatherwood |
First Address | Boston, MA 02215-5221 |
Second Address | Richmond, CA 94801-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 18/10/2018 |