NPI | 1255196838 |
---|---|
Former Name | SUSAN BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71014940A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014940A) |
Enumeration Date | 2024-02-14 |
Last Update Date | 2025-01-09 |