Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 149779 | CA |
NPI | 1467776948 |
---|---|
Provider Name | Elisabeth Jenefer Diver |
First Address | Palo Alto, CA 94304 |
Second Address | Palo Alto, CA 94304-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2010 |
Last Update Date | 07/08/2017 |