Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD-44082 | IA |
NPI | 1063770519 |
---|---|
Provider Name | Dr. Danielle Sonia Liudahl |
First Address | West Des Moines, IA 50266-9313 |
Second Address | West Des Moines, IA 50266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 17/08/2021 |