Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC30793 | CA |
NPI | 1437437951 |
---|---|
Provider Name | Shilpa Agrawal |
First Address | Porter Ranch, CA 91326-3708 |
Second Address | Porter Ranch, CA 91326-3708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2011 |
Last Update Date | 01/08/2011 |