NPI | 1336175876 |
---|---|
Former Name | DEBORAH DUNN HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: OH 35-04-6429) |
Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301047227) |
208D00000X General Practice (Licence: HI 7307) | |
208D00000X General Practice (Licence: KY TP440) | |
Enumeration Date | 2006-06-25 |
Last Update Date | 2011-07-27 |