NPI | 1558769356 |
---|---|
Former Name | LINDSAY DAWN KOEDAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP000917) |
Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: SD CP000917) |
Enumeration Date | 2014-12-09 |
Last Update Date | 2022-03-30 |