NPI | 1235576661 |
---|---|
Former Name | CHELSEA RENAE HEPPNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 14192) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 58250) |
Enumeration Date | 2013-05-24 |
Last Update Date | 2021-11-15 |