NPI | 1669744033 |
---|---|
Former Name | ELIZABETH MARY OLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172751) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 33336913) |
Enumeration Date | 2012-02-01 |
Last Update Date | 2015-10-20 |