| NPI | 1306036017 |
|---|---|
| Former Name | DIANE ADELE FJELSTAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ND 10846) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND 10846) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 50501) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: SD 7025) | |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2021-02-08 |