| NPI | 1740376722 |
|---|---|
| Former Name | SUSAN ELIZABETH TYLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY F381090) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 325709) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-09-25 |