Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | CA |
NPI | 1841350238 |
---|---|
Provider Name | Ms. Kelly Buffo |
First Address | Santee, CA 92071-4295 |
Second Address | Santee, CA 92071-4295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |