| 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 |