| NPI | 1649249210 |
|---|---|
| Former Name | SUSANNE MICHELLE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 121589) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000378) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC000568) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-04-10 |