NPI | 1841683331 |
---|---|
Former Name | SUSAN RAE TOBIAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LG-0000819) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE LG-0000819) |
Enumeration Date | 2015-03-09 |
Last Update Date | 2021-06-16 |