NPI | 1306188149 |
---|---|
Former Name | HELEN O CARLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H92558) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO175406) |
207Q00000X Family Medicine (Licence: WA OP60937525) | |
Enumeration Date | 2013-03-19 |
Last Update Date | 2021-09-14 |