NPI | 1902121932 |
---|---|
Former Name | ERIN ROSE RUNDQUIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60683659) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-21997) |
Enumeration Date | 2010-04-01 |
Last Update Date | 2024-01-19 |