Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | DRN28 | CA |
NPI | 1699062489 |
---|---|
Provider Name | Dr. Tina Marie Cowan |
First Address | Palo Alto, CA 94304-1204 |
Second Address | Palo Alto, CA 94304-1204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 30/06/2011 |