NPI | 1104028281 |
---|---|
Former Name | SUSAN C. FITZ-WILLIAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP81562) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL ARNP821072) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2022-09-13 |