NPI | 1083898555 |
---|---|
Former Name | SUZANNE LOUISE ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 1064581A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H4713) |
208000000X Pediatrics (Licence: TN 32102) | |
Enumeration Date | 2007-12-19 |
Last Update Date | 2017-07-21 |