NPI | 1962730507 |
---|---|
Former Name | SUZANNE MARIE HEYNOSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010571) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN561265) |
Enumeration Date | 2009-11-19 |
Last Update Date | 2009-11-19 |