| 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 |