| NPI | 1356421622 |
|---|---|
| Former Name | KIMBERLY SUE LUNDGREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 45236) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 04-43142) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-02-09 |