Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 350 | CA |
NPI | 1043555154 |
---|---|
Provider Name | Robyn Pool |
First Address | Thousand Oaks, CA 91360-2031 |
Second Address | Thousand Oaks, CA 91360-2031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2012 |
Last Update Date | 29/11/2012 |