NPI Profile for EDWIN C BROADNAX in RIVERSIDE, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
1041S0200X |
| NPI Number | 1518248640 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/02/2011 | |
| Last updated | 09/02/2011 - About 15 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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EDWIN C BROADNAX
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