NPI | 1902342520 |
---|---|
Former Name | SUSAN LYNN GLADOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 140643) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20715) |
Enumeration Date | 2017-01-07 |
Last Update Date | 2019-11-06 |