NPI | 1912240060 |
---|---|
Former Name | BROOK JOHANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WA AP61178764) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61178764) |
Enumeration Date | 2013-03-27 |
Last Update Date | 2021-11-24 |