| NPI | 1699847004 |
|---|---|
| Former Name | LISA MARY SUSSDORFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner Neonatal, Critical Care (Licence: VT 101-0025747) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-12-29 |