Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1780963165 |
---|---|
Provider Name | Nicole Therese Carpenter |
First Address | Sacramento, CA 95834-1644 |
Second Address | Sacramento, CA 95834-1646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2011 |
Last Update Date | 16/08/2011 |