| NPI | 1588287510 |
|---|---|
| Former Name | SIDNI OLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11257) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MN 2284138) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2021-11-03 |