Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | Y2859416 | CA |
NPI | 1952856205 |
---|---|
Provider Name | Miss Sana Alexandrovna Nodelman |
First Address | Los Angeles, CA 90046-2359 |
Second Address | Los Angeles, CA 90046-2359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2016 |
Last Update Date | 16/08/2016 |