| NPI | 1568685956 |
|---|---|
| Former Name | MELODY ANN JORDAHL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01080289A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 40515) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2021-06-09 |