Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1568758191 |
---|---|
Provider Name | Craig Lowe |
First Address | Riverside, CA 92507-3432 |
Second Address | Riverside, CA 92507-3432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 22/06/2011 |