Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 408 | CA |
NPI | 1104016310 |
---|---|
Provider Name | Miss Kimberly Sue Brown |
First Address | San Jose, CA 95124-3038 |
Second Address | San Jose, CA 95124-3038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 10/02/2012 |