| NPI | 1962989046 |
|---|---|
| Former Name | SUSAN SANDERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704251926) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704251926) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2025-06-02 |