| NPI | 1740360197 |
|---|---|
| Former Name | ERICA LYN ESSELSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60097510) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL-2113) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-10-07 |