NPI | 1932799525 |
---|---|
Former Name | MOLLY SCHELLACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 8066) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R43825) |
Enumeration Date | 2021-01-19 |
Last Update Date | 2022-11-23 |