Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist | 23974 | CA |
NPI | 1134551633 |
---|---|
Provider Name | Michele Lau |
First Address | Santa Cruz, CA 95062-4456 |
Second Address | Santa Cruz, CA 95062-4456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2013 |
Last Update Date | 07/08/2013 |