Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 49105 | MN |
NPI | 1023077625 |
---|---|
Provider Name | Dr. Julie Lin Becker |
First Address | Wyoming, MN 55092-8013 |
Second Address | Wyoming, MN 55092-8013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 07/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
K18462 | (02) |