NPI | 1093711566 |
---|---|
Former Name | DAWN M. JORGENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 67538) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 4610) |
Enumeration Date | 2005-06-21 |
Last Update Date | 2021-11-30 |