Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 52037-21 | WI |
NPI | 1003038381 |
---|---|
Provider Name | Alison Rae Sampson |
First Address | Marshfield, WI 54449-5703 |
Second Address | Marshfield, WI 54449-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 01/12/2010 |