Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1841966579 |
---|---|
Provider Name | Miss Victoria Fairweather |
First Address | Playa Vista, CA 90094-2721 |
Second Address | Playa Vista, CA 90094-2721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2021 |
Last Update Date | 22/08/2021 |