Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 225 | CA |
NPI | 1073763512 |
---|---|
Provider Name | Sharon Craig |
First Address | Fremont, CA 94555-1437 |
Second Address | Fremont, CA 94555-1437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2008 |
Last Update Date | 21/09/2008 |