NPI | 1053720441 |
---|---|
Former Name | SUSAN MARINA BECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 105921) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 32978) |
Enumeration Date | 2014-08-11 |
Last Update Date | 2024-01-25 |