Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 31715 | CA |
Y | 213ER0200X | Radiology | 31715 | CA |
NPI | 1245608694 |
---|---|
Provider Name | Monica Egan Knowles |
First Address | Novato, CA 94949-5709 |
Second Address | Novato, CA 94949-5709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2015 |
Last Update Date | 03/12/2015 |