| NPI | 1942994322 |
|---|---|
| Former Name | MARY ELLEN CASPERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 13680) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 13680) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2024-06-13 |