Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | PT12595 | CA |
NPI | 1932149564 |
---|---|
Provider Name | Kristina Svenson-Brown |
First Address | San Rafael, CA 94901-1746 |
Second Address | Novato, CA 94945-5038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 21/05/2009 |