Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 19905 | CA |
NPI | 1033253075 |
---|---|
Provider Name | Dr. Joan Margaret |
First Address | Oakland, CA 94609-1114 |
Second Address | Oakland, CA 94609-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |