NPI | 1588344220 |
---|---|
Former Name | MOLLY WISSELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10867) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2515435) |
Enumeration Date | 2023-07-18 |
Last Update Date | 2023-10-11 |