Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 19836 | CA |
NPI | 1184945727 |
---|---|
Provider Name | Lori Umanzio |
First Address | Palm Springs, CA 92262 |
Second Address | Palm Springs, CA 92262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 17/06/2010 |