Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | CERTIFIED | CA |
NPI | 1427228071 |
---|---|
Provider Name | Vera June Groff |
First Address | Santa Rosa, CA 95407-4548 |
Second Address | Santa Rosa, CA 95404-4538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 10/03/2008 |