NPI | 1396176715 |
---|---|
Former Name | SUSAN DARLENE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: WI 941000-30) |
Enumeration Date | 2013-12-11 |
Last Update Date | 2013-12-11 |