Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 29720 | IA |
NPI | 1033169768 |
---|---|
Provider Name | Christine Marie Holm |
First Address | Dubuque, IA 52001-7301 |
Second Address | Dubuque, IA 52001-7301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1106310 | (05) | IA |
F72980 | (02) |