NPI | 1902960990 |
---|---|
Former Name | KARE ANN HENRIKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 32015) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A061158) |
207Q00000X Family Medicine (Licence: MO 2006020977) | |
Enumeration Date | 2006-12-21 |
Last Update Date | 2019-08-20 |