| NPI | 1124574157 |
|---|---|
| Former Name | BLEXY SUSAN JOSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP131743) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP131743) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2023-12-29 |