Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 29989 | CA |
NPI | 1427327469 |
---|---|
Provider Name | Mrs. Nataliya K Kopilow |
First Address | Napa, CA 94558 |
Second Address | Napa, CA 94558-4610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2011 |
Last Update Date | 20/12/2011 |