Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 4578 | CA |
Y | 225XE1200X | Ergonomics | 4578 | CA |
NPI | 1700095304 |
---|---|
Provider Name | Mr. Vincent R Smith |
First Address | San Diego, CA 92123-4428 |
Second Address | San Diego, CA 92123-4428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |