| NPI | 1548300684 | 
|---|---|
| Former Name | SUSAN MARIE JIMENEZ | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9228497) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP 9228497) | 
| Enumeration Date | 2007-02-07 | 
| Last Update Date | 2010-12-01 |