NPI | 1114905585 |
---|---|
Other Name | SUSAN KATHERINE BLICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174390) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN143856) |
Enumeration Date | 2006-01-05 |
Last Update Date | 2019-02-08 |