NPI | 1609256908 |
---|---|
Former Name | SUSAN HAVERLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9353130) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339384) |
Enumeration Date | 2015-06-02 |
Last Update Date | 2025-07-29 |