Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 95015349 | CA |
NPI | 1023618394 |
---|---|
Provider Name | Kathrine Lee |
First Address | Santa Clara, CA 95050-6226 |
Second Address | San Francisco, CA 94143-2351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2020 |
Last Update Date | 27/10/2020 |