| NPI | 1124004445 |
|---|---|
| Former Name | REBECCA SUE SUDENBAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 45223) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 40372) |
| 208000000X Pediatrics (Licence: TN MD40372) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2021-11-22 |