| NPI | 1831579853 |
|---|---|
| Former Name | SHANDA SUZANNE THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL APRN11025689) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: AL 1-134326) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: GA 208000000X) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2023-09-14 |