NPI | 1396156675 |
---|---|
Former Name | CHELSEA LYNN BERDAHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13174) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1389) |
Enumeration Date | 2014-05-08 |
Last Update Date | 2023-12-15 |