NPI | 1366286940 |
---|---|
Former Name | SUZANNE MICHELLE TOLLIVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM 81067) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 81067) |
Enumeration Date | 2024-06-19 |
Last Update Date | 2024-11-20 |