| NPI | 1063152791 |
|---|---|
| Former Name | KAREN CHRISTIANE JOHNSRUDE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ RNP289863) |
| Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: WA 60607354) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2023-10-16 |