Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 8426 | WI |
NPI | 1003435728 |
---|---|
Provider Name | Sarah Hotovy |
First Address | Eau Claire, WI 54702-1510 |
Second Address | Eau Claire, WI 54703-5222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2020 |
Last Update Date | 15/09/2020 |