| NPI | 1902430523 |
|---|---|
| Former Name | SUZANNE MARIE BAGENT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209023126) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2020005632) |
| 163W00000X Registered Nurse (Licence: MO 2014003169) | |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2022-07-18 |