NPI | 1184878654 |
---|---|
Former Name | SUSAN MARY GRIMES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP 18840) |
Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: CA 385018) |
Enumeration Date | 2008-11-11 |
Last Update Date | 2016-04-04 |