NPI | 1376741082 |
---|---|
Former Name | SUZANNE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 3095240-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 3095240-4405) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2022-12-08 |