Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 21756-020 | WI |
NPI | 1356558498 |
---|---|
Provider Name | Dr. Diana Elizabeth Lardy |
First Address | Madison, WI 53711-1617 |
Second Address | Madison, WI 53704-3643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |