Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 447 | CA |
NPI | 1053356618 |
---|---|
Provider Name | Emma Susan Williamson |
First Address | Healdsburg, CA 95448 |
Second Address | Santa Rosa, CA 95405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 08/07/2007 |