NPI | 1295788271 |
---|---|
Former Name | SUSAN J LONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP000178) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD R018015) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2022-04-18 |