NPI | 1770928558 |
---|---|
Former Name | ALEXIS B HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD175758) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-05-07 |
Last Update Date | 2016-12-19 |