Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | PT 14819 | CA |
Y | 225XE1200X | Ergonomics | PT 14819 | CA |
NPI | 1760617781 |
---|---|
Provider Name | Ms. Michelle Eisenberg |
First Address | La Jolla, CA 92039-2501 |
Second Address | San Diego, CA 92130-2189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 19/05/2009 |