Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 12802 | SD |
N | 207N00000X | Dermatologist | R-10928 | IA |
N | 207N00000X | Dermatologist | R-11289 | IA |
NPI | 1033647177 |
---|---|
Provider Name | Lainee Goettsche |
First Address | Sioux Falls, SD 57108-2591 |
Second Address | Sioux Falls, SD 57108-2591 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2017 |
Last Update Date | 09/08/2021 |