| NPI | 1942538764 |
|---|---|
| Former Name | SUSAN MARIE DITTMEYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NV RN14237) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.187363) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-07 |