Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 40101 | IA |
NPI | 1275732968 |
---|---|
Provider Name | Marie Eve Asselin |
First Address | Iowa City, IA 52242-1001 |
Second Address | Iowa City, IA 52242-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 13/07/2007 |