Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC 15954 | CA |
NPI | 1093110363 |
---|---|
Provider Name | Dr. Christine Farlow |
First Address | Escondido, CA 92046-2335 |
Second Address | Escondido, CA 92025-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2014 |
Last Update Date | 29/10/2014 |