| 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 |