Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | DC26267 | CA |
NPI | 1992985717 |
---|---|
Provider Name | Dr. Julie A Amundsen |
First Address | Petaluma, CA 94952-4054 |
Second Address | Petaluma, CA 94952-4054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 06/06/2017 |