Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A106037 | CA |
Y | 208600000X | Surgeon | A106037 | CA |
N | 2082S0105X | Plastic Hand Surgeon | A106037 | CA |
NPI | 1619174521 |
---|---|
Provider Name | Natalie Driessen |
First Address | Palm Desert, CA 92260-2710 |
Second Address | Palm Desert, CA 92260-2710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 10/04/2019 |