NPI | 1043284375 |
---|---|
Former Name | SUZANNE MICHELLE GOMEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX L4954) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A73474) |
Enumeration Date | 2006-02-14 |
Last Update Date | 2017-11-08 |