NPI | 1356521868 |
---|---|
Former Name | JESSICA MARIE SUSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: GA RN165793) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN165793) |
Enumeration Date | 2007-11-13 |
Last Update Date | 2021-11-17 |