NPI | 1114155447 |
---|---|
Former Name | SUSAN LYNN NEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2011-01495) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08708600) |
207P00000X Emergency Medicine (Licence: PA MT186185) | |
207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA MT186185) | |
207PT0002X Emergency Medicine, Medical Toxicology (Licence: NC 2011-01495) | |
Enumeration Date | 2009-06-25 |
Last Update Date | 2024-02-21 |