NPI | 1730794892 |
---|---|
Former Name | JULIE MARIE NISSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0995857-NP) |
Enumeration Date | 2020-09-14 |
Last Update Date | 2020-09-14 |