NPI | 1639582273 |
---|---|
Former Name | HEIDI ELAINE SKOOG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 65168) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2014016497) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2019-07-08 |