Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 14399 | CA |
NPI | 1982972196 |
---|---|
Provider Name | Donald Cameron Holmes JR. |
First Address | Fresno, CA 93704-1137 |
Second Address | Fresno, CA 93704-1137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2011 |
Last Update Date | 02/12/2011 |