| NPI | 1003174004 |
|---|---|
| Former Name | SUSAN J DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2016009600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 34741) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2025-03-19 |