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 |