Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | #1014 | MN |
NPI | 1134284342 |
---|---|
Provider Name | Maureen C. Dahl |
First Address | Princeton, MN 55371-6423 |
Second Address | Princeton, MN 55371-6423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |