NPI | 1235267329 |
---|---|
Former Name | SUSAN MARIE GODSCHALX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200250033NP) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2009-12-21 |