NPI | 1811617434 |
---|---|
Former Name | ALEXANDRA SUSSMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350294) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 350294) |
Enumeration Date | 2022-09-01 |
Last Update Date | 2022-09-01 |