NPI | 1477561256 |
---|---|
Former Name | KRISTYN D SOUSOU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302806-1) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 302806) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2023-07-05 |