Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 05-29352 | KS |
N | 207VG0400X | Gynecologist | 0529352 | KS |
NPI | 1871554998 |
---|---|
Provider Name | Cathy L Dahl |
First Address | Lawrence, KS 66044-2215 |
Second Address | Lawrence, KS 66044-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 20/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I43568 | (02) | KS |