Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 248123 | CA |
NPI | 1033289988 |
---|---|
Provider Name | Ms. Winifred Lee Star |
First Address | San Francisco, CA 94115-3416 |
Second Address | San Francisco, CA 94115-3416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P26564 | (02) | CA |