Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 6376 | CA |
NPI | 1104072313 |
---|---|
Provider Name | Deborah Sylvia Dewar |
First Address | San Francisco, CA 94118-4416 |
Second Address | San Francisco, CA 94143-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 07/08/2008 |