| NPI | 1841436664 |
|---|---|
| Former Name | SUSAN MARIE BERTNIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041283981) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209004032) |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2008-12-29 |