NPI | 1316611692 |
---|---|
Former Name | SARAH MARY JOHANSON BARDER WELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 8301) |
Enumeration Date | 2021-08-02 |
Last Update Date | 2021-08-02 |