NPI | 1821026485 |
---|---|
Former Name | MARY AGNES OLMSCHEID |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0064049) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 44037) |
207Q00000X Family Medicine (Licence: LA 200028) | |
Enumeration Date | 2006-06-30 |
Last Update Date | 2021-10-06 |