| NPI | 1346447190 |
|---|---|
| Other Name | LEIF BRYNOLF JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5002627) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NC 213163) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2019-07-08 |