Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC15196 | CA |
NPI | 1013010396 |
---|---|
Provider Name | Ms. Katherine Margaret Federle |
First Address | Menlo Park, CA 94025-4318 |
Second Address | Menlo Park, CA 94025-4318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |