NPI | 1801391750 |
---|---|
Former Name | SUZANNE MARIE RESIDORI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 993276) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993276-NP) |
Enumeration Date | 2018-03-23 |
Last Update Date | 2021-12-22 |