Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 527334 | CA |
NPI | 1003057365 |
---|---|
Provider Name | Dr. Elizabeth Marlow |
First Address | San Francisco, CA 94107-1302 |
Second Address | San Francisco, CA 94107-1302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2009 |
Last Update Date | 29/10/2012 |