NPI | 1700229846 |
---|---|
Former Name | TRACY HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 62995-20) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 62995-20) |
Enumeration Date | 2013-04-08 |
Last Update Date | 2016-08-01 |