| NPI | 1487408761 |
|---|---|
| Former Name | MADELINE AMANDA EGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 80288) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 34467) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2026-08-12 |