NPI | 1356590392 |
---|---|
Former Name | SUSAN KAY RUSCHE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9105988) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1197) |
Enumeration Date | 2008-09-15 |
Last Update Date | 2013-08-29 |