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 | 208000000X Pediatrics (Licence: TN MD40372) |
207R00000X Internal Medicine (Licence: TN 40372) | |
Enumeration Date | 2005-12-19 |
Last Update Date | 2024-11-05 |