Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57. 010977 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | 39484 | IA |
N | 2080P0205X | Pediatric Endocrinologist | 50680 | MN |
NPI | 1104029008 |
---|---|
Provider Name | Dr. Katie Marie Ulring Larson Ode |
First Address | Iowa City, IA 52242-1007 |
Second Address | Iowa City, IA 52242-1007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 18/05/2011 |