NPI | 1689011520 |
---|---|
Former Name | ANDREA MARIE AHRENDSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 42287) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60623728) |
Enumeration Date | 2013-06-02 |
Last Update Date | 2024-08-13 |