NPI | 1962649384 |
---|---|
Former Name | SUSANNA G ANGLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3005923) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005923) |
Enumeration Date | 2009-01-08 |
Last Update Date | 2015-06-30 |