Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 677455 | PA |
NPI | 1508228941 |
---|---|
Provider Name | Guernica Cleveland |
First Address | Norristown, PA 19401-4543 |
Second Address | Philadelphia, PA 19144-1202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 24/03/2016 |