Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 429173 | CA |
NPI | 1003106386 |
---|---|
Provider Name | Marlene Solomon Lim |
First Address | Fresno, CA 93727-4744 |
Second Address | Fresno, CA 93727-4744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2011 |
Last Update Date | 08/04/2011 |