Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | A133612 | CA |
NPI | 1104168756 |
---|---|
Provider Name | Dr. Alexandra Holly Freeman |
First Address | Fresno, CA 93721-1431 |
Second Address | Clovis, CA 93611-6889 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2013 |
Last Update Date | 14/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2557862 | DRIVERS LISCENCE (01) | DC |