| NPI | 1184759243 |
|---|---|
| Former Name | SUZANNE ELISE LIVINGOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA 719) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004979) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2011-04-25 |