NPI | 1255887717 |
---|---|
Former Name | SUSANNA ELYSE OSTERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131935) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP131935) |
Enumeration Date | 2016-08-25 |
Last Update Date | 2025-01-15 |