Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 11035 | MN |
NPI | 1023124179 |
---|---|
Provider Name | Dr. Catherine Elaine Wurm |
First Address | Saint Cloud, MN 56303-4489 |
Second Address | Saint Cloud, MN 56303-4489 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |