| NPI | 1336775931 |
|---|---|
| Former Name | ELISE KIRSTEN JOHANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: NJ 25ME00071401) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: PA MW010570) |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2024-08-29 |