| NPI | 1336204718 |
|---|---|
| Former Name | JUDITH M SUPENSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110283) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 110283) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2013-02-13 |