NPI | 1023479995 |
---|---|
Former Name | SARAH ELIZABETH SHOUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340272) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 678660) |
Enumeration Date | 2016-03-18 |
Last Update Date | 2019-01-24 |