| NPI | 1508503525 |
|---|---|
| Former Name | SUSANA ELIZABETH GONZALEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 9635) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 2459743) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-10-25 |