| NPI | 1548377872 | 
|---|---|
| Former Name | SUSAN J GEBHARD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 62714-030) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1561-033) | 
| Enumeration Date | 2006-08-24 | 
| Last Update Date | 2007-07-08 |